Sept. 02--CHEYENNE -- It's not easy to decide on the medical care you want at the end of your life.
But it's a necessary decision and one that should be made early enough so people know your wishes, a nationally known doctor said Wednesday.
People should talk with each other about these decisions, Dr. Daniel P. Sulmasy said Wednesday.
He spoke about ethical issues in care at the end of life before a packed crowd at Cheyenne Regional Medical Center. The presentation was open to the community.
Family members or others should know whether their father or wife, for example, want doctors to withhold extraordinary measures. Their wishes must be clearly spelled out.
"Most of the decisions that are made at the end of life are made at points where the patient is not able to speak for himself or herself anymore," Sulmasy said.
It's difficult for those who must make such decisions without direction from the patient, he said.
When that happens, these family members experience stress equal to that of someone whose house has burned down, he said.
Loved ones try to figure out what is best for the patient or what the patient would want. But their decisions aren't always accurate. Studies show that family members selected the choices the patient would have wanted only 66 to 68 percent of the time, he said.
Talking with each other helps guarantee that the patient's wishes will be carried out.
Sulmasy is a Franciscan brother, doctor and author and a nationally-known expert in medical ethics. He is the Kilbride-Clinton professor of medicine and ethics in the Department of Medicine and Divinity School at the University of Chicago.
There are advanced directives to help make sure a patient's decisions are followed, he said.
These are documents called living wills or durable powers of attorney. They provide direction that patients want if they can't speak for themselves.
A person must be terminally ill for a living will to take effect.
In Wyoming, two doctors must declare a person is terminally ill for a living will to be effective, said Dr. Harmon Davis. He introduced Sulmasy at the program.
A living will can tell whether a patient wants cardiopulmonary resuscitation or the use of a breathing ventilator, for example.
Sulmasy prefers the durable power of attorney, also called a health-care proxy. The proxy means that there's a human being who knows what the patient wants, he said.
Unlike a living will, the durable power of attorney is not solely for the terminally ill. A person can simply designate who they want to make end-of-life decisions about their health care.
Sulmasy commended the work of hospice care to help comfort people who are dying.
"Dying is not easy. You only get to do it once," he said, "You want to attend to all of the needs of a dying person."
He visited the Davis Hospice Center in Cheyenne on Wednesday and praised the facility. "It's magnificent," he said, adding that only one other hospice in the country is nicer.
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